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Permit CITY TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: MEC2006 -00618 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/5/2006 PARCEL: 1S135CC-02000 SITE ADDRESS: 10360 SW MEADOW ST ZONING: R -4.5 SUBDIVISION: THE MEADOW LOT: 005 JURISDICTION: TIG Project Description: Gas furnace and AC install. CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN: 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Owner: FEES STEVE VALDEZ • Description Date Amount 10360 SW MEADOW ST TIGARD, OR 97223 [MECH] Permit Fee 12/5/200E $72.50 [TAX] 8% State Surcha 12/5/200€ $5.80 Total $78.30 Phone: 503- 971 -7430 Contractor: FOUR SEASONS HEATING & A/C INC. PO BOX 238 NEWBERG, OR 97132 REQUIRED ITEMS AND REPORTS Contact #: PRI 503- 538 -1950 FAX 503 -538 -0165 Reg #: LIC 97152 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: It ,6 , Permittee Signature: 6 012101(e-414 Call 503.639.4175 by 7:00 a.m. for inspections that business day. This permit card shall be kept in a conspicuous place on the Job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Dec 05 06 08:O1a Malcolm Lamb 5035380165 p.2 4',. Mechanic Permit - I cli1 . E® FOR OFFICE ` US USE _�G /8 City of Tigard R"`r Q g Datc;Oy:l /O�O BJ�ca�� 13125 SW Hall Blvd., Tigard, OR 97223 (DEC ?, P 0 2006 Plan Review // Phone: 503.639.4171 Fax: 503.598.196 V t„ 2006 U yr�Sri I ` I t ;y, (toter t'enuie - ' Inspection Line: 503.639.4175 � Date Ready/13y: Jurta: ® Sc e Pate 2 for Internet: www.ci.ligard.or.us CITY OF TIGAR Nolitied/Men/MelliMd: Supplemental Informatiu BUILDING DIVISION TYPE OF WORK • COMMERCIAL FEE* SCHEDULE - USE CHECI. ❑ New construction &Addition /alteration/replacement Mechanical permit lees' are based on the value of the woe performed. Indicate the value (rounded to the nearest dolla ❑ Demolition ❑ Other ma hanical materials. equipment. labor, overhead. and pot ' CATEGORY OF CONSTRUCTION Value: S � RESIDENTIAL EQUIPMENT I SYSTEMS FEE'. 1 l' and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special inftrnraoion use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. Ea. JOB SITE INFORMATION AND LOCATION Hcating/cooliug Air conditioning or heat pump Job site address: ` A**3 (O O S l.._) (requires site plan slimming placement) 14.05 City /Slate/ZIP: .. t•. (!, AR-. 't n a -_^-c Furnace 100.000 BTU (ducts'eeuts) 14.00 Furnace 100.000+ BTU (duclvventz) 17.90 Suite/bldg. /apt. no.: I Project name: Gas heat pump 14.00 Cross street /directions to job site: Duct work 14.00 Hydnmic hot water system 14.00 Residential boiler (radiator or hydmnic) 14.00 Unit heaters (fuel -type, not electric'. in -wall, in -duct, suspended. etc. 111.00 Flue/vent for any of above 10.00 Subdivision: I Lot no.: Other: 10.00 Tax neap /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 • • � q,\ 1 w � `T ` 1 • . - Flue " 0.M Gas fireplace nt fireplace oc r water heater or gas 10.00 `�r'aQ.m►�C vent tti /� l i n,place 10.l ilt Log lighter (gas) 10.0(1 Wood/pellct stove 10.00 �/ Wood fireplace/insert nsert 10.0 +3 PROPERTY OWNER I o TENANT Chimney /liner/Ilue/vent 10.00 Other: I 10.00 Name: s }„c_,, 42, v q\. k•e_Z Environmental exhaust and ventilation Range hood /other kitchen Address: , e ,... L. � `.......N ��_tna e 6.4-- _ equipment 10.00 City/State /ZIP 1Z:s4P--- � a�� Single-duet 10.01) r Single -eruct cxtwust (bathrooms, Phone: 5 e3) cv1 t Li.3 Fax: ( ) toilet cwnpanmcnts, utility roots) 6.80 GrAPPLICANT "13 CONTACT PERSON Attic /crawlspace fans 10.011 Other: 10.00 Business name'�„ L i .. t t 1S Nk ,t'- ti /(t Fuel piping — Contact name: jk...s._.L w1 S5.40 for first four; $1.00 for each additional • Address: 1 _ Furnace. etc. B 8� — fit i�•MS a. .� �J4 i' 'I" 1 • Gas halt pump City /State/ZIP: �... - _` ".., _ — Wall/sus ended /unit heater Phonc.4912 C _1� �� `' Fax: :tS 4) ��� ' � 1�� i Cr c e Fireplace �— E-mail: Range • CONTRACTOR Barbecue Business names Utz 'ttT�� �� - r - \ - /C Clothes dryer (gas) Other. 1 Address: \ 6 S — . � ���Q MECHANICAL PERMIT FEES` City /Statc/ZIP: J� c �r t 13 Subtotal C Minimum permit fee ($72.50) Phone: ( bl, S3'q.— l i o ■ S Fax' ) ) e7� c Dl low Plan review (25% of pennit lie) CCI3 lie.: State surcharge (ti% of pennit fee) TOTAL PERMIT FEE Authorized signature � q v�,r— � � � This permit application t s ir permit is not obtained tiff [lays after it t tuts been accepted as complete. I Print nam a N . a I Date: ♦ •Q__ ` Fee methodology set by Tri- County 0uildiag Industry Service I: is Ituildinp •1'ennits:MIt(•- PetntuApp.dnc 12.03 „ 440-4617T (11..02.00141:10 Dec 05 06 08:O1a Malcolm Lamb 5035380165 N p .3 P(- r.. • a property lines to? i y 5 —� HtI cAS E N SW Meadow St.